Healthcare is awash with difficult decisions. Patients need to choose between treatment options that having no guarantee of working. Care providers are on the other end of that decision process, evaluating what options are worth sharing with patients and their families and which are not. Payers have an entirely different role in the process, attempting to encourage appropriate use of healthcare resources by choosing to pay for certain procedures and not for others.
There’s no question that it’s a messy process. Differing groups with differing priorities all weighing in on the same choices is a recipe for conflict. The conflicts bubble to the surface when someone says no on an issue when someone else wants the answer to be yes.
This issue has come up more and more often and we’re going to have more issues in the future. Drug shortages in recent years have forced some facilities to choose one patient to receive a particular medication while another does not. In other scenarios we see healthcare providers stockpiling medications, protecting their patients in the process but exacerbating shortages elsewhere. Likewise, as attempts to rein in healthcare costs continue, more patients in dire circumstances will get treatment pre-approval requests rejected.
This happens every day, and families are most often the ones left feeling disappointment and anger. Typically, though, these discussions, decisions, and the aftermath play out behind closed doors.
What happens when they don’t?
What happens when a disappointed family turns to social media and through a clever bit of jujitsu uses your own success in social media to turn your fan base against you? How do you respond?
This is the challenge facing Children’s Hospital of Philadelphia (CHOP). CHOP Nephrologists refused to perform a kidney transplant on a four-year-old girl because she has a genetic defect known as Wolf-Hirschhorn Syndrome (WHS). WHS causes many problems including mental retardation. There are many reasons why transplant programs refuse transplants. In this case, according to the family, the case was denied due to the child’s mental retardation.
The mother, Chrissy Rivera, tells her account of the encounter on a blog she co-authors about the challenges of raising a child with WHS. On its own, this engages a group of sympathetic and motivated people on her behalf.
The larger public relations challenge presented to CHOP comes on Facebook, where their wall has been dominated for days by pleas to rethink the decision. This, of course, puts the message in front of the hospital’s 32,000+ Facebook fans, many of whom are liking, sharing and commenting.
I am profoundly unqualified to comment on the moral issues underlying this decision. But it does illustrate the challenges that healthcare organizations face when dealing in a socially connected world.
This type of challenge is far more difficult to address than typical consumers brands (such as Nestle) that have faced social media backlash. Hospitals can’t respond to claims directly due to patient confidentiality issues.
So in essence, CHOP’s in a fight with one hand tied behind their back!
With those hurdles in the way, CHOP is dealing with the issue well:
- Despite a great many challenges from page visitors, CHOP is carefully avoiding any discussion of the patient’s case or health situation and remains respectful of the opinions and feelings of everyone engaged in the discussion.
- Although I’m certain that it is uncomfortable, they appear to be leaving all visitor posts on their page. A good choice as deleting negative posts would likely further anger the community.
- CHOP has issued a statement acknowledging that they are listening and reiterating their policies, values and history as relates to this issue. A custom Facebook tab has been created and is the default landing page for anyone coming to visit CHOP on Facebook.
- The organization is discussing the issue with the family offline.
Of course, none of this has made the issue go away. It is, however, the best approach available from a PR perspective. This is simply one of those issues that must be addressed operationally and individually with the family. Until that happens, encouraging open discussion and being good listeners is the best way to mitigate the damage.